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Friday, March 1, 2013

Troponin

Troponin is a complex of three regulatory proteins (troponin C,
troponin I and troponin T) that is integral to muscle contraction in
skeletal and cardiac muscle, but not smooth muscle. Troponin, working in
conjunction with tropomyosin, functions as a molecular switch,
regulating muscle contraction in response to changes in intracellular
Ca2+ concentration.

Certain subtypes of troponin (cardiac troponin I and T) are very
sensitive and specific indicators of damage to the heart muscle
(myocardium). They are measured in the blood to differentiate between
unstable angina and myocardial infarction (heart attack) in patients
with chest pain or acute coronary syndrome. Normal levels of cTn I in
the blood are very low. A patient who had suffered from a myocardial
infarction would have an area of damaged heart muscle, and would have
elevated cardiac troponin levels in the blood. Cardiac TnI has a similar
release pattern to CK-MB, the earlier indicator of heart damage; both
can be measured 4-6 hours after the onset of pain. The level of cTnI
remains elevated for a much longer period of time (6-10 days), which
provides a longer window of detection of cardiac injury and allows for
the detection of acute myocardial infarction (AMI) much earlier after
the onset of ischemia (4 hours). Recent data have identified a
measurable relationship between cardiac troponin levels and long-term
outcome after an episode of chest discomfort. These studies suggest that
the use of the cTnI demonstrates high predictive value in evaluating
the high-risk group of unstable angina patients.

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